Table of ContentsView AllTable of ContentsPurposeHow It’s DoneSide EffectsBefore the TestAfter the TestResults
Table of ContentsView All
View All
Table of Contents
Purpose
How It’s Done
Side Effects
Before the Test
After the Test
Results
A tilt table test is a non-invasive medical test used to evaluate unexplained fainting (syncope), dizziness, or rapid heartbeat (tachycardia).
The test involves changing a person’s positioning to see how their heart rate and blood pressure respond. A positive tilt table test result can indicate autonomic dysfunction, postural orthostatic tachycardia syndrome(POTS), or a similar condition.
This article discusses the tilt table test. It explains what it is, how to prepare for it, and what the results can mean.
Verywell / Cindy Chung
Why Would You Need a Tilt Table Test?
The tilt table test evaluates your blood pressure and heart rate as your position changes. It starts with lying flat in the prone position on the table. The table is tilted to a standing position as your vital signs are monitored.
A tilt table study is used to identify the cause of unexplained symptoms such as:
The test aims to replicate your symptoms so your healthcare provider can get a better sense of the circumstances under which you have these experiences.
A positive tilt table test means your blood pressure or heart rate changes significantly and can indicate an underlying condition.
What a Tilt Table Test Looks For
When you stand up, your cardiovascular system adjusts to prevent too much of your blood from pooling into your legs. This causes a mild increase inheart rateand a constriction (narrowing) of the blood vessels in your legs.
Under normal circumstances, these adjustments occur very quickly and are barely noticeable.
However, in certain health conditions, postural changes can cause a significant fluctuation in blood pressure or heart rate. These include:
Ruling Out SeizuresThe tilt table test can also be useful in distinguishingepilepsyfrom syncope, as seizures are not always associated with physical movements, and sometimes syncope is associated with jerking movements.
Ruling Out Seizures
The tilt table test can also be useful in distinguishingepilepsyfrom syncope, as seizures are not always associated with physical movements, and sometimes syncope is associated with jerking movements.
How Is a Tilt Table Test Performed?
The test requires a special table that can be tilted to different angles and is usually done in an outpatient suite or hospital.
You lie down on the tilt table, and your healthcare provider will secure you to the table with straps to maintain your position when the table is tilted. You will also be connected to the following:
Throughout the test, your team will monitor your blood pressure, heart rate, and oxygen levels, and ask about your symptoms.
You may be given medication such as nitroglycerin or Isuprel (isoproterenol), which speeds the heart rate, making symptoms more noticeable.
To start, the team will assess your vital signs while you are lying flat. Then the table will be mechanically tilted to an upright position. Because you are secured, this requires no effort from you.
You may be monitored at different angles for 10 to 15 minutes and assessed in a motionless standing position for 10 to 60 minutes.
How Long Is a Tilt Table Test?
The tile table test takes about an hour. However, the entire process—from check-in to release—can take a few hours.
After the test, some people may feel dizzy or lightheaded, while others may recover right away.
It is almost impossible to predict how long the positional changes or medications will affect you, so it is best to anticipate a two- to three-hour recovery time when the test is done.
You should also plan to have someone drive you home after the test.
How Uncomfortable Is a Tilt Table Test?
A tilt table test is not painful but can be uncomfortable to stay in one position for the duration of the test.
Since the test is aimed at simulating your symptoms, you may experience the following during the tilt table test:
You will be monitored throughout the test. If you pass out during a tilt table test, the test administrator provider will likely give you medication or adjust the angle of the table so you are lying down again.
If you experience other uncomfortable symptoms, tell your medical team. They can administer treatment or change the tilt of the table to relieve physiological changes.
How to Prepare for the Test
If you take any medications that alter your heart rate or blood pressure, your healthcare provider will let you know when or if you need to stop taking them before the test.
Do not eat or drink for three to four hours before the test. This is because it may induce nausea.
Your insurance may require pre-authorization for a tilt table test. Your healthcare provider’s office should be able to help you navigate the process.
How Much Does the Test Cost?
If you are paying out of pocket, the price will vary among different facilities. The average cost of a tilt table test in 2018 was $535.
Contraindications
A tilt table test should not be performed on people with the following:
Not only will these conditions predispose you to a high chance of fainting, but there is little chance that the test could provide healthcare providers with additional useful information if you already know that you have these conditions.
You may experience mild dizziness within the first 24 hours after your test, which should resolve when you lie down and rest. If symptoms persist for longer than a day, call your healthcare provider.
The following are not expected outcomes of a tilt table test. Seek urgent medical attention if you experience the following:
What Do the Results Mean?
The tilt table test provides information that your healthcare providers can use as part of making a diagnosis, but the test itself does not provide any definitive answers. It may take a few days for the test results to be available.
Anegative tilt table testmeans that you experience a minor drop in blood pressure and a slight increase in heart rate when moving from sitting to standing, which is within normal ranges.
Apositive tilt table testmeans that you experience a significant or abnormal change in heart rate or blood pressure that warrants further investigation. For example:
Summary
A tilt table test is a non-invasive procedure that is used to assess the cause of fainting, dizziness, lightheadedness, or unexplained falls.
The test uses a special table that tilts to evaluate how your heart rate and blood pressure fluctuate upon moving upright.
While some variations are normal, significant changes can indicate dysautonomia, orthostatic hypotension, POTS, or vasovagal syncope.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Teodorovich N, Swissa M.Tilt table test today - state of the art.World J Cardiol. 2016;8(3):277-82. doi:10.4330/wjc.v8.i3.277Grossman SA, Badireddy M.Syncope. Treasure Island, Fl: StatPearls Publishing; 2019.American Heart Association.Tilt-table test.Chen H, Mercader M, AlGaeed M, Koubeissi M.Yield and cost-effectiveness of tilt table tests combined with video-EEG.Epileptic Disord. 2019;21(6):555-560. doi:10.1684/epd.2019.1109Song PS, Kim JS, Park J, et al.Seizure-like activities during head-up tilt test-induced syncope.Yonsei Med J. 2010;51(1):77-81. doi:10.3349/ymj.2010.51.1.77Additional ReadingFurukawa T.Role of head-up tilt table testing in patients with syncope or transient loss of consciousness.J Arrhythm. 2017;33(6):568-571. doi:10.1016/j.joa.2017.08.002Khodor N, Matelot D, Carrault G, et al.Kernel based support vector machine for the early detection of syncope during head-uptilt test.Physiol Meas. 2014;35(10):2119-34. doi:10.1088/0967-3334/35/10/2119Kohno R, Adkisson WO, Benditt DG.Tilt table testing for syncope and collapse.Herzschrittmacherther Elektrophysiol. 2018;29(2):187-192. doi:10.1007/s00399-018-0568-9
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Teodorovich N, Swissa M.Tilt table test today - state of the art.World J Cardiol. 2016;8(3):277-82. doi:10.4330/wjc.v8.i3.277Grossman SA, Badireddy M.Syncope. Treasure Island, Fl: StatPearls Publishing; 2019.American Heart Association.Tilt-table test.Chen H, Mercader M, AlGaeed M, Koubeissi M.Yield and cost-effectiveness of tilt table tests combined with video-EEG.Epileptic Disord. 2019;21(6):555-560. doi:10.1684/epd.2019.1109Song PS, Kim JS, Park J, et al.Seizure-like activities during head-up tilt test-induced syncope.Yonsei Med J. 2010;51(1):77-81. doi:10.3349/ymj.2010.51.1.77Additional ReadingFurukawa T.Role of head-up tilt table testing in patients with syncope or transient loss of consciousness.J Arrhythm. 2017;33(6):568-571. doi:10.1016/j.joa.2017.08.002Khodor N, Matelot D, Carrault G, et al.Kernel based support vector machine for the early detection of syncope during head-uptilt test.Physiol Meas. 2014;35(10):2119-34. doi:10.1088/0967-3334/35/10/2119Kohno R, Adkisson WO, Benditt DG.Tilt table testing for syncope and collapse.Herzschrittmacherther Elektrophysiol. 2018;29(2):187-192. doi:10.1007/s00399-018-0568-9
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Teodorovich N, Swissa M.Tilt table test today - state of the art.World J Cardiol. 2016;8(3):277-82. doi:10.4330/wjc.v8.i3.277Grossman SA, Badireddy M.Syncope. Treasure Island, Fl: StatPearls Publishing; 2019.American Heart Association.Tilt-table test.Chen H, Mercader M, AlGaeed M, Koubeissi M.Yield and cost-effectiveness of tilt table tests combined with video-EEG.Epileptic Disord. 2019;21(6):555-560. doi:10.1684/epd.2019.1109Song PS, Kim JS, Park J, et al.Seizure-like activities during head-up tilt test-induced syncope.Yonsei Med J. 2010;51(1):77-81. doi:10.3349/ymj.2010.51.1.77
Teodorovich N, Swissa M.Tilt table test today - state of the art.World J Cardiol. 2016;8(3):277-82. doi:10.4330/wjc.v8.i3.277
Grossman SA, Badireddy M.Syncope. Treasure Island, Fl: StatPearls Publishing; 2019.
American Heart Association.Tilt-table test.
Chen H, Mercader M, AlGaeed M, Koubeissi M.Yield and cost-effectiveness of tilt table tests combined with video-EEG.Epileptic Disord. 2019;21(6):555-560. doi:10.1684/epd.2019.1109
Song PS, Kim JS, Park J, et al.Seizure-like activities during head-up tilt test-induced syncope.Yonsei Med J. 2010;51(1):77-81. doi:10.3349/ymj.2010.51.1.77
Furukawa T.Role of head-up tilt table testing in patients with syncope or transient loss of consciousness.J Arrhythm. 2017;33(6):568-571. doi:10.1016/j.joa.2017.08.002Khodor N, Matelot D, Carrault G, et al.Kernel based support vector machine for the early detection of syncope during head-uptilt test.Physiol Meas. 2014;35(10):2119-34. doi:10.1088/0967-3334/35/10/2119Kohno R, Adkisson WO, Benditt DG.Tilt table testing for syncope and collapse.Herzschrittmacherther Elektrophysiol. 2018;29(2):187-192. doi:10.1007/s00399-018-0568-9
Furukawa T.Role of head-up tilt table testing in patients with syncope or transient loss of consciousness.J Arrhythm. 2017;33(6):568-571. doi:10.1016/j.joa.2017.08.002
Khodor N, Matelot D, Carrault G, et al.Kernel based support vector machine for the early detection of syncope during head-uptilt test.Physiol Meas. 2014;35(10):2119-34. doi:10.1088/0967-3334/35/10/2119
Kohno R, Adkisson WO, Benditt DG.Tilt table testing for syncope and collapse.Herzschrittmacherther Elektrophysiol. 2018;29(2):187-192. doi:10.1007/s00399-018-0568-9
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